GAINESVILLE, Fla., Aug 18, 2003 (United Press International via COMTEX) -- University of Florida psychiatrists have come up with guidelines to help doctors determine how much time on the Internet is enough to be unhealthy.

There are enough concerns to consider whether Internet addiction should be considered a new psychiatric disorder, said Dr. Nathan Shapira of the university's McKnight Brain Institute.

He said Web surfing, e-mailing, instant messaging, gaming, shopping, downloading music and visiting chat rooms become troublesome when they interfere with someone's job or social life.

Healthcare professionals are trying to figure out when high Internet use is dysfunctional, and whether unhealthy Internet use is a stand-alone disorder or a byproduct of other disorders, such as manic depression.

In an article published in the current issue of "Depression and Anxiety," Shapira and other scientists propose criteria to diagnose potentially unhealthy Internet use.

"The only way we as psychiatrists will figure out whether Internet addiction exists as a separate entity from other psychiatric illnesses is if we have consistent criteria to evaluate it," said Shapira, an assistant professor of psychiatry.

At issue is whether there is "an irresistible preoccupation that impairs aspects of a patient's life and can't readily be explained as another psychiatric disorder," Shapira said.

He said problem users might spend more time online than they had planned, underestimate the time they spent and feel a rise in tension just before going online.

"One of the first things we did is divorce problematic Internet use from the criteria used to describe other impulse control disorders," Shapira said.

"The problem with taking a predefined diagnosis, such as for pathological gambling, and just changing the word 'gambling' to 'Internet' in the description is that one tends to draw premature conclusions and not explore other diagnoses," he said.

In another article, published recently in "Current Psychiatry," the university devised five questions to evaluate patients' computer involvement using the word mouse.

-- More than intended time spent online.

-- Other responsibilities neglected.

-- Unsuccessful attempts to cut down.

-- Significant relationship discord because of use.

-- Excessive thoughts or anxiety when not online.

Shapira devised the criteria after conducting face-to-face psychiatric evaluations of 20 volunteers who identified themselves as having problems with the Internet and 17 randomly selected college students with varying levels of Internet use.

He found the volunteers who called themselves problematic Internet users had, on average, five pre-existing psychiatric problems, such as bipolar disorder, depression or alcohol abuse.

In addition, they were online more than 30 hours per week, and their nonessential Internet use was 10 times greater than their essential use, such as job- and school-related activities -- 28 hours compared with 2.8 hours.

"It's very useful for some people to spend high amounts of time on the Internet for work, school and recreation," said Jeffrey I. Cole, director of the University of California, Los Angeles Center for Communications Policy.

"For the vast majority of Americans, Internet use doesn't come at the expense of other activities. However, there is something inherently addictive in the Internet because it's interactive and it's dynamic -- it's never the same as you left it," said Cole, in another survey.

"Clearly, there are people who stay online longer than they intended, and other parts of their lives do suffer. It would be interesting to know whether that's clinically diagnosable," he said.

Shapira said in the "Depression and Anxiety" article, that people who have problems with the Internet are older than most people think.

"All of the studies that actually evaluated patients have a pretty consistent profile that problematic Internet users are older than what you might expect, in the (early) to mid-30s, they are male and female, they spend about 28 hours a week in pleasure, recreational or personal computer use, and they report problematic use for about three years," Shapira said.

"What we've defined are people who have dysfunctional high use. What's missing is we have no idea if this is a separate disorder," he said.

Shapira said more research is needed to determine whether Internet addiction should be a separate listing in the Diagnostic and Statistical Manual of Mental Disorders, considered the standard for psychiatric diagnoses in the United States.

The alternative would be classifying it as an impulse control disorder, such as pathological gambling.

"It's disheartening to consider how little we know about the effects of the Internet on humans and how few resources from companies, foundations and the government are devoted to looking at the problems," Shapira said.

"That's why we proposed our criteria -- to enable doctors to make a diagnosis and to define a specific population for study," he said. "Taking a random set of people and calling them Internet addicts without some scientific basis cannot lead to effective treatments."

Copyright 2003 by United Press International.

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Last updated: 08/21/2003 - 07:19 AM